It is difficult for alcoholics to get out of addiction – many fight against drinking all their lives. For this reason, researchers have now carried out a Cochrane meta study to investigate how effective different methods are on the way to abstinence. The focus was on how well the concept of Alcoholics Anonymous (AA) performs compared to traditional forms of therapy. The study found that the twelve-step Alcoholics Anonymous program and its self-help group system helps more participants maintain abstinence than other forms of therapy; it is at least as good in terms of other parameters.
Alcoholics Anonymous originated in the US city of Akron in 1935. At that time, two men were looking for the best way to overcome their alcohol addiction and founded the first self-help group. Over time, the concept of regular lay meetings led and organized and the program of twelve steps developed. It starts with the insight that you can no longer control your drinking alone, the admission of your addiction to others and the willingness to change addictive behaviors. Also part of the program is the care of new participants by sponsors who have been dry for a long time. There are now more than 118,000 AA groups worldwide with more than two million members.
Comparing therapies
However, Alcoholics Anonymous is not without controversy because of its quasi-religious features and the groups led by lay people. Psychologists and addiction therapists in particular often doubt that this method works better than targeted behavioral or motivational therapies, as lead author Keith Humphreys of the Stanford School of Medicine confirms: “I thought: How dare these people do simple things, for whom I have all these degrees, ”says the researcher. In order to investigate how well Alcoholics Anonymous actually helps their participants, he and his colleagues have now carried out a comparative analysis. To do this, they evaluated the data from 27 studies with a total of 10,565 participants and compared AA and twelve-step programs with classic clinical forms of therapy. They determined whether and to what extent the participants reduced their drinking level, how long they remained abstinent and what effect this had on their state of health.
The evaluations showed that alcoholics who tried to get dry with the help of AA had an at least as good, often even better chance of success. If the AA groups strictly followed the rules of the twelve-point program, the chances of success were even significantly higher: 42 percent of the AA participants were dry one year after the start of therapy, whereas the traditional methods, such as cognitive behavioral therapy, were opposed only 35 percent. Most of the AA participants were also abstinent 24 and 36 months after the start of therapy, as the researchers report. In the case of alcoholics who did not achieve complete abstinence, at least the intensity of drinking decreased just as much as with classic therapies. The results for AA were just as good as those of the other methods for addiction symptoms and health status.
“It works!”
“There is thus high-quality evidence that the interventions of Alcoholics Anonymous and the twelve-step program for sustained abstinence are more effective than other established treatments,” said Humphreys and his colleagues. Because in the studies, these results could be demonstrated for people in five different countries and from very different age groups and social backgrounds. The principle of regular group meetings and close supervision over a long period of time seems to best help against addiction in the long term. Humphreys therefore believes it makes good sense for psychologists and medical professionals to encourage their patients to join an AA group after participating in shorter-term therapies. “It obviously works,” says the researcher.
And the meta-study found one more thing: “In terms of health care costs, policymakers should be interested to know that four of the five relevant studies we identified showed significant cost savings for AA and related twelve-step clinical programs to increase AA participation” , reports John Kelly from Harvard Medical School. “This suggests that these programs could significantly reduce health system costs.”
Source: Cochrane Database of Systematic Reviews, doi: 10.1002 / 14651858.CD012880.pub2